Stomach tube or the like



Feb. 28, 1933. J R w ss 1,899,781

STOMACH TUBE OR THE LIKE Filed April 27, 1932 John Ewell Patented Feb.28, 1933 Jo n; RUSSELL 'rwIss, or New YORK, N. .Y.

. s'romacn TUBE on THE Application med an 27,

The invention concerns an appliancefor drawing fluids from, orintroducing the same into the duodenumstomach,- or the like, and

relates particularly to the employment in such appliance of a'bucketwith the conduit tube, and also ofa'ball or weight connectedwith-thebucket in such manner as to act as a leader, having freedom ofmovement in various directions relative thereto. Y r 1 I a The inventionconsists in the features,-and

arrangement I and combination of parts hereinafter described and outinthe claims.

Inthedrawing: Figure 1 is a sectionalview of the invention in one form.i Fig. 2-is a lengthwise sectional view of the .bucket member. v 3 Fig.3 is a transverse sectional view-of the bucket member. 7

particularly pointed Fig. 4 is a view of another forinof the invention.l l

Fig. 5 is a lengthwise section of the bucket memberof Fig.4.

Fig. 6'is a transversesectiona'lview of the bucket member of Fig 4. 1 I4 The flexible duodenal tube is shown in part at'l, This is formed ofrubber and 'isof about in diameter, and approximately four and a halffeet long. This tube carries at its end a hollow member 2 generallyknown as a bucket. It'is formed of metal and is intended to provide themeans for furnishing the proper arrangementof inlet openings tothetube,*or in case fiuidsa're to be introduced into'the patient" theseopen ings form'the' outlet from the tube. This metal memberis providedwith end portions or shoulders 3 ofslightly larger diameter 7 than therubber tube which may be attached thereto by a wrapping of silk thread.The

rubber tube fits upon a hollow nipple 2a extending from the end face ofthis metal tip or bucket. The bucket intermediate "of. the

end portions or shoulders 3'is provided with perforations in the form ofslots 4 in its wall and these are of a length toextend substantiallyfrom one end portion to the other. These slots form the inlet openingsto-the in connection position of 'ders or end di'ate part of the bucketreduced diameter in respect to the end porshown it is of sphericalshape.

19: 2. Serial recovers. V v p v x I bucket and hence to the tube whenthe device these openings form the outlets from the tu when used forintroducing. fluids into the patient. p

There are preferably four of these, slots -90 apart. Leading to' theends of certain.

of these slots are groovesor' channels. 5; in the shoulders orendportions 3. The'ldisthe slots 4 and the channels 5- relative'to theshoulder or-endjportionsof the bucket is such that a free communication:is afforded to and from the tube 2 when'the' appliance is in operation,because the .s houl; I

portions 'of the bucket will pre-/ Vent the wall of the stomach orduodenum when in-collapsed condition from closing these slots andchannels by afl'ording stops or bearing surfaces for the said collapsed,wall, thus acting to hold itofl' from the 'slots'70 and channelssufficiently to maintain 1 them in open condition. Preferably theintermeis of considerably tions or shoulders, andthe slots are formed fa*in this reduced portion, and the channels 5 lead to these slots.Furthermore this reduced intermediate portion; of the bucket may be ofgenerally concaved formation, its smallest diameter being its length,and gradually ameter towards the end portions orshoul- "ders, thoughabout midway" of '80 increasing -in d-ithe invention is not limited inthis respect. I f This concave formationavoids the exist-' ence ofabrupt shoulders or edges on -the bucket. Beyond this terminal tip orbucket is located a weight or leader member- 6.

This may be of various forms,=-for instance,

ovoid or globular. In thepartic'ulrr formeo apart'fromthe bucketaconsiderable distance, say two inches,and is connected to the bucket bymeans which will allowthe ballor weightto have in large degree free 'domof movement, independently of the bucket both laterally in respect tothe axis of the "bucket and flexible tube,- and-also about its own axis,or in other words, about that pole which isattached to-the bucket'filoois used for evacuation, or, on the-contrarg It is spaced V and ballrespectively, and inrespect to the ballor weight The means for attachingthis ball or weight to the bucket may assume various forms, but in eachform it is desirable that the freedoin of movement of the ball relativeto the bucket and main tube be provided for. In Fig. 1 this connectionis shown as rubber tubing than the rubber conduit tube. 1 It lendsitself to convenient attachment both to the ball and to the bucket,eachof said parts having a projection marked respectively 8 and 9, overwhich the rubber tube is stretched, and secured by a silk thread. Thediameter of these projections is somewhat less than the adjacent partsof the bucket,

the connection is such that the working surface of the ball is availableat bycarrying the end of the thread under the all points excepting thecomparatively small area covered by the attached end of the rubber tubeconnection, and the stud surrounded thereby, i being noted that theballis of larger diameterthan the said ball and the connecting tube.

The silk thr'ead windings are held without knotti-ng said thread. Thismay be done v wrapped strand or strands, so asto be held clamped inposition thereby.

, In Fig. 4 is shown a slightly diifere'nt form of bucket. The maindifference between it and the form described above is that :take placerelative to the bucket which, therefore, will be; relieved in largemeasure leading weight or member, for example a chain 1( coveredby Thechainis' {the intermedlate slotted part is not concaved.

. he slots and channels above described are present in this form alsoand are so. disposed thestomnotjact as a closure The slots in this formthereto are marked 56;. I

In thisform the connection between the ball is shown as a flexible atubular rubber sheath 7a. attached to a swivel pin 10 having a head 11hearing; on awasher 12 within the hollow bucket, the said pin beingadapted to turn about its axis; to accommodate any rolling action thatthe ball may tend to have.- In this swivelling action the movement will:oftendency to turn about its axis and twist the main conduit tube 1.The flexible connecting member or chain is ball by a pin 13 screwthreaded into the latattached to the ter. ,Thecovering tube 7a ofrubber, which is intended vto protect the. chain, and also to avoidcontact of said chain with the wall of r .the cavity in which the deviceoperates, may be made of highly flexible rubber tubing fastened to thepin 13 by a silk thread wrapping. At its other end this rubber sheath isattached bya silkthreadwrapping to. a collar'14 which is mountedrotatively upon 7. Thistube is more highly flexible joint between pposition,,forthe purpose of lavage,

have freedom of movement in various directions relative to the bucket.

The-ball in this form of the appliance, like that first described,presents its rounded surface atfront, rear and sides for contact withthe wall of he cavity in which it operates, it

being noted that the diameter of the ballis considerably greater thanthat of the flexible connection, so that all sides of the ball areexposed, as just stated, in large degreeln use, the rounded terminalmass or ball G is inserted into the mouth of the patient followed by thebucket, and the. attached long, narrow, flexible, conduit tube, by meansof which the bucket'and mass below it are pro elled through theesophagus and stomach to the distal end of the stomach'known as thepylorus.

the duodenum, assisted by gravity. The terminal mass draws the bucketafterit until the bucket reaches the approximate location ofth'e openingof the pancreatic and common bile ducts into the duodenum,its arrival at'this pointbeing indicated by the appearance of bile at the upper end ofthe tube. [The upper end of the tube is then held. in place by the hand,or by some external temporary attachment, during which time the bucketis also maintained in its position by traction from below, exerted bythe rounded terminal mass and its flexible couplin n r eera ty ortestinal action, OI bOthLf peristaltic in- .The bucket may remainthis-position as long as necessary. Thecontents of the duo-. be drainedoutby gentle suction num may orfsiphonage; Fluids may be injected bymeans of syringe for the purpose of stimulating the flow" of bile andpancreatic secretions, after which the secretions and stimu- -.latingfluids may be'drained out. Fluids may also beintroduced, with the bucketin this nutrition, or for specific medicinal purposes. After completionof the desired procedure, the bucket isw-ithdrawn by exerting gentletraction on the part of the long narrow tube outside the mouth.

. An advantageof this improved type of"ap-,

plian'ce is that it is composed of twov units,

a small, light, metal bucket and a rounded or ovoid terminalmassin whichthe weight of the unit is localized. This arrangement allows great easeofentrance intothe duodenum and provides assurance of keeping the bucketin positionfollow'ing the u eef ti g Here, the rounded terminal massbecomes .engagedin the pyloric orificeand is drawn downward bytheperistaltic action of g, which is held-j flating fluids, because ofthe following 'fea- 3 ing intestinal wall may be.

tures a flexible coupling is introduced through the tube.

The terminal rounded mass is highly mobile, easily seized upon andpropelled through the stomach and duodenum towards;

its destination at the opening of the bile and pancreatic ducts by theperistaltic waves of the stomach and duodenum. This action is aided bythe long, light, and flexible characterof the connecting coupling, whichis of a lesser diameter than that, of the terminal I tion bycollapse orconstrictlon of the intes- IIIHSS.

short, and of small diameter, is easily drawn after the rounded mass,carrying Wltli 1t the attached tube, to the duodenum, where thesecretions of the are obtained. 7

The metal bucket collecting these scoretions isretained at the properplace by holding the long, narrow, flexible tube externally, whichpreventsthe further progress of the bucket, and by the traction exertedby the pancreas and'biliary tract rounded mass or weight and itselongated,'-

flexible coupling, which prevents'the regurgitation of the tube fromtheduodenum back into the stomach. 7 1

It will be seen from the abovethat the feature of separating the light,metal bucket from the mass weight of'the tip, is an important one, aswell as the feature of connecting these parts by a highlyflexibleconnection allowing for substantially complete freedom of the weight toassume different positions.

Further advantages are found in the cone struction of the metal bucketitself. The shoulders make the total diameter of the bucket at its endsslightly larger than that of the long flexible rubber tube or thediameter of the elongated flexible coupling with the terminal mass. Thisdifference in diameter is not enough to impede the progress of thebucket in either direction in the ga strointestinal canal; it is,however,suflicient to prevent the walls of the stomach or duodenum fromcollapsing down upon the four slots in the bucket. This collapsing wouldmake impossible the flow of fluidsthrough the slots into the long,flexible tubing and create a vacuum which would prevent movement of thebucket. These shoulders or en: largements constitute guards to protectthe slots against closure. I

The grooves in the shoulders provide for the free in-flow and outflow offluids from above or below the bucket through the slots, into or outfrom the long,

The terminal rounded mass at theend of.

The metal bucket, being light in weight;

.spirit of the invention. V. V It will be understood that Where parts in1 shown in Fig.

ing from being flexible tube, re-

gardless' of how constricting the surround,

A further advantage of these grooves is that they prevent the formationof avacuum between thetwo shoulders,-in cases of a constrictedintestinal wall, with the subsequent necessary immobility of the bucket.

' An advantage in the construction of the slots is that they are longenough, and have a width almost as great as the'lumen of the tinal wall.v

' The coupling connection for the ball consistinof a thin, narrow,flexible member of greater flexibility thanthat of the long, flexi eilex ending to the mouth, is an advantage in the adaptation of th t i L,

mass toirregular or roundedsurfaoes and to-theopening of the pyloricorifice.

i Except as maybe interpreted from the apqpen'ded claims, the

not limited to the forms or characteristicsv of the elements describedand scopetofi the invention is shown herein, certain ofthe-- featuresbeing susceptible to modification without one form'can be used in theother form, they are to be regarded as existing in said other form. Thusthe swivel connection in Fig. 4

may be substituted for the'coupling member lfor holding the ball weight.

I claim: I 1. An appliance of the class described, comprising a flexibleconduit tubeand anattached bucket mcmbenprovided with'an openingin itswall, and with means at opposite ends of the opening to guard said open-1ng against closure from the wall of the cavity in which, the bucket islocated- 2. In anappliance of the class described, a flexible conduittube,a bucket member attached thereto having anopening through its walland an enlarged portionat each side of said opening to guard the sameagainst closure from the collapsed wall of the cavity in I which thebucket is located.

3. An appliance of the class described, comprising a flexible conduittube and an atdeparting; from" the tached bucket member provided with an7 opening in its wall, and with means to guard saidopening againstclosure from the wall of the cavity in which the bucket is located, saidguard means having a channel or space leading to the said opening, toprevent said openplaced out of service. i

J 4i. An appliance of the class described'comprising a flexible conduittube and a bucket ends of said bucket, which ends provide bearings toprevent closure of said opening by 'a collapsed wall of the cavityinwhich said bucket is located.

5. An appliance of the class described com- I prising a flexible conduittube and a bucket "attached thereto, substantially circular in.

member attached thereto having an opening in its wall for the passageo'f fiuid, said open comprising a flexlble condu1t tube, a bucket ingbeing depressed in relation to the end portions of the bucket, wherebysaidends guard the opening'against closure from a collapsed wall of thecavity in which the bucketis located.

6. An appliance of the class described, comprising a flexible conduittube and a bucket attached thereto, said bucket having its wallintermediate its relatively larger end portions depressed relative tosaid end portions and perforated, and a channel extending through saidrelatively larger end portions and communicating with the perforationfor the passage of fluid between said channeland the interior of thebucket and conduit tube, said channel opening to the outside of thebucket and guarded by the end portion against closure by a collapsedwall of the' cavity in which the bucket is located.

7. An appliance according to claim 6 in which the slot and channelextend longitudinally of the bucket;

' 8. An appliance of the class described comprising a flexible conduittube, and a bucket cross section and concaved on its exterior lengthwisewith a slot intermediate its end portions, and with achannel through theend portion connecting with the slot and communicating with the outsideto prevent closure of communication through the slot to the interiorofthe bucket and the tube, substantially as described.

'9'. An appliance of the class described comprising a flexible conduittube with a passage associated tlierewitliioi' the flow of fluid to orfrom the outside oi said tube at or near one end thereof, and a leaderweight member spaced apart from that end of said tube with which saidpassage is associated, and'a flexible connection between said weightmember and the said end portion of said tube, substantially asdescribed.

10. An appliance according to claim 9'in which said weight member isrounded on its outer surface. I

11. An appliance according to claim 9 in which the leader weight is oflarger transverse dimension than the thickness of the flexibleconnection.

12. An appliance accordingto claim 9 in whichthe leader weight issubstantially in the form of a ball, substantially as described. 13. Anappliance according to claim 9 in which the flexible connection allowsthe weight member to have movement about its.

axis.

1 4. An appliance according to claim 9 in which the. flexible connectionincludes a swivel joint for allowing the weight member to turn about itsaxis. 7

15. An appliance according to claim 9 in which the flexible connectionhas a swivel joint between itself and the tubular conduit.

16.'An appliance of the class described comprisin a flexible conduittube, and an attached bucket member having an opening in its wall,said'bucket member being pros vided with wall portions in outstandingrelation in respect to said opening to guard it against closure by whichthe bucket is located.

18. An appliance of the class described comprising a bucket memberhaving an end wall provided Wltll a pro1ectionfor the attachment ofaflexible memberg the end wall being of greater diameter than theflexible member tobe attached to the projection, said endwall at oneside of the projection having an opening communicating with the interiorof the bucket. f v

19. An appliance of the class described,

the wall of the cavity in comprising a flexible conduit tube andanattached bucket member having an opening in its wall to one side ofthe flexible conduit tube and av second openlng in its end communicatingwith the first named opening to prevent complete closure of the firstnamed opening in the event that a portion of the wall of the cavity inwhlch the bucket is located overlies the first named opening.

-20. An appliance of the class-described,

comprising a flexible conduit-tube and anat:

tached bucket member PIOViClGClQ with a lateral opening and with guardmeans to prevent closure oi said opening by the wall of the cavity inwhich the bucket is located, said guard means having an aperture whichopens. at the endjof the bucket and communicates with said lateralopening to provide access to thelateral opening in the event that aportion of the wall of the cavity in which the bucket is locatedoverliesthe lateral opening.

In testimony whereof, I affix my signature.

JOHN RUSSELL TWISS.

